Organization
PREMIER WOMEN'S HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIQUE J. SMITH MD (MEDICAL DOCTOR/OWNER/MEMBER)
(678) 418-6990
Entity
Organization
Contact information
Practice address
5900 HILLANDALE DR STE 325, LITHONIA, GA 30058-3892
(678) 418-6990
(678) 418-6986
Mailing address
5900 HILLANDALE DR STE 325, LITHONIA, GA 30058-3892
(678) 418-6990
(678) 418-6986
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000740737I
—
GA
Enumeration date
08/01/2007
Last updated
07/08/2021
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